Thymidylate synthase expression and prognosis in colorectal cancer: a meta-analysis of colorectal cancer survival data
Thymidylate synthase expression and prognosis in colorectal cancer: a meta-analysis of colorectal cancer survival data
复制标题
结直肠癌中胸苷酸合酶的表达和预后：结直肠癌生存数据的荟萃分析
DOI：
10.5301/jbm.2012.9584
复制
发表时间：
2012-07-01
影响因子：
2
通讯作者：
Wang, Xiuwen
中科院分区：
文献类型：
--
作者：
Chen, Yao;Yi, Cuihua;Wang, Xiuwen
背景：虽然许多研究已经探讨了胸苷酸合成酶（TS）在结直肠癌中的预后作用，但尚未达成共识。本荟萃分析的目的是更准确地估计TS表达在根治性切除和辅助化疗治疗的局部癌症中的预后意义。材料和方法：17项符合条件的研究报告了2,893例按TS表达分层的患者的生存率，使用固定或随机效应模型进行汇总。主要结局指标为风险比（HR）。结果：总生存率的总HR为1.01 (95% CI 0.74 ~ 1.39, p= 0.947)， I-2为64.4%。无病生存的总HR为1.36 (95% CI 0.97-1.89, p= 0.072)， I2为75.8%。在TS蛋白检测亚组中，无病生存的总HR为1.72 (95% CI 1.02-2.89, p= 0.042)， I-2为81.3%。结论：我们的荟萃分析显示，在辅助治疗中，TS表达并不预示较差的无病生存期或较差的总生存期。因此，我们认为将TS表达作为手术和辅助化疗治疗的II期和III期结直肠癌患者的预后因素是不合适的。
Background: Although many studies have investigated the prognostic effect of thymidylate synthase (TS) in colorectal cancer, no consensus has been reached. The aim of this meta-analysis was to obtain a more precise estimate of the prognostic significance of TS expression in localized cancers treated by curative resection and adjuvant chemotherapy.Materials and method: Seventeen eligible studies reporting survival in 2,893 patients stratified by TS expression were pooled using a fixed- or random-effects model. The main outcome measure was hazard ratio (HR).Results: The overall HR for overall survival was 1.01 (95% CI 0.74-1.39, p= 0.947), with an I-2 of 64.4%. The total HR for disease-free survival was 1.36 (95% CI 0.97-1.89, p= 0.072), with an I2 of 75.8%. In the TS protein-tested subgroup, the total HR for disease-free survival was 1.72 (95% CI 1.02-2.89, p= 0.042),with an I-2 of 81.3%.Conclusion: Our meta-analysis showed that, in the adjuvant setting, TS expression does not predict a poorer disease-free survival or a worse overall survival. Therefore, we believe that it is inappropriate to regard TS expression as a prognostic factor for patients with stage II and stage III colorectal cancer treated by surgery and adjuvant chemotherapy.